Delayed presentation with cardiac tamponade due to blunt thoracic trauma and ruptured left atrial appendage

Delayed survival due to cardiac chamber rupture in the setting of blunt thoracic trauma is rare. Delay can occur due to transport from a remote location as reported herein when patient was operated upon 5 h later following left atrial rupture causing cardiac tamponade. We emphasize the need for high index of suspicion of cardiac tamponade in patients who show hemodynamic instability. Cardiopulmonary bypass may be required when there is uncontrolled bleeding following opening of the pericardium.